Digestive cancer surgery in the era of sentinel node and epithelial-mesenchymal transition |
| |
Authors: | Nadia Peparini |
| |
Institution: | Nadia Peparini, Azienda Sanitaria Locale Roma H, via Mario Calo’ 5 - 00043 Ciampino, Italy, Italy |
| |
Abstract: | Lymph node involvement is one of the most important prognostic indicators of carcinoma of the digestive tract. Although the therapeutic impact of lymphadenectomy has not been proven and the number of retrieved nodes cannot be considered a measure of successful cancer surgery, an adequate lymph node count should be guaranteed to accurately assess the N-stage through the number of involved nodes, lymph node ratio, number of negative nodes, ratio of negative to positive nodes, and log odds, i.e., the log of the ratio between the number of positive lymph nodes and the number of negative lymph nodes in digestive carcinomas. As lymphadenectomy is not without complications, sentinel node mapping has been used as the rational procedure to select patients with early digestive carcinoma in whom nodal dissection may be omitted or a more limited nodal dissection may be preferred. However, due to anatomical and technical issues, sentinel node mapping and nodal basin dissection are not yet the standard of care in early digestive cancer. Moreover, in light of the biological, prognostic and therapeutic impact of tumor budding and tumor deposits, two epithelial-mesenchymal transition-related phenomena that are involved in tumor progression, the role of staging and surgical procedures in digestive carcinomas could be redefined. |
| |
Keywords: | Lymph node count Lymph node ratio Sentinel node Tumor budding Tumor deposits |
本文献已被 维普 等数据库收录! |
| 点击此处可从《世界胃肠病学杂志(英文版)》浏览原始摘要信息 |
|